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Published on: May 5, 2018
Characterizing Fetal Hemorrhage in a Perinatal Autopsy Cohort.
Erica Price1, Sunitha Suresh2,3, Linda M Ernst1,4
1Department of Pathology and Laboratory Medicine, Endeavor Health, USA.
Summary
Fetal hemorrhage (FH) is a challenging autopsy finding. This study differentiates FH into the amnionic sac from fetomaternal hemorrhage (FMH), aiding diagnosis through placental and fetal autopsy examination.
Area of Science:
- Perinatal pathology
- Forensic pathology
- Obstetrics
Background:
- Fetal hemorrhage (FH) is an underrecognized cause of perinatal death.
- Limited literature exists on placental and autopsy findings in FH.
- Characterizing FH is crucial for accurate diagnosis at autopsy.
Purpose of the Study:
- To describe fetal and placental findings in cases of FH.
- To differentiate FH into the amnionic sac from fetomaternal hemorrhage (FMH).
- To improve recognition of FH as a cause of perinatal death.
Main Methods:
- Autopsy series of perinatal deaths involving fetomaternal hemorrhage (FMH) and FH into the amnionic sac.
- Inclusion of singleton pregnancies with Kleihauer Betke (KB) testing.
- Categorization into FMH with ≥40% fetal blood volume, FMH ≤39%, and suspected FH with negative KB test.
Main Results:
- 20 cases identified from 691 autopsies.
- FMH ≥40% cases showed normal placental weight, villous edema, and fetal hydrops.
- FH into the amnionic sac cases had smaller placentas, disrupted fetal vessels, and less fetal hydrops.
Conclusions:
- This study differentiates FMH and FH into the amnionic sac.
- Highlights the importance of careful placental and fetal autopsy examinations.
- Aids in the identification of FH as a cause of perinatal death.
